Exam 4 - Diarrhea Flashcards
(T/F): fluid and electrolyte imbalance leading to dehydration is the major complication of diarrheal illness
True
What can be an underlying cause of diarrhea?
- traveling
- foods that may have caused food poisoning
- recent vacations in children
- food intolerances
What is a vaccination that has an ADR of diarrhea?
Rotavirus vaccinations in infants may have a mild adverse effect of diarrhea
Loperamide adverse effects
Occasional dizziness
Constipation
Loperamide limit
Used for a MAXIMUM of 48 hours
What is the treatment of choice for mild-moderate dehydration diarrhea?
Fluid and electrolyte replacement w/ oral rehydration solutions
What is the preferred agent when vomiting is the predominant clinical symptom of acute gastroenteritis?
Bismuth subsalicylate
Loperamide RARE adverse effects
Fatigue
Dry mouth
Abdominal pain
Vomiting
Abdominal distention
Nausea
Hypersensitivity reactions
(Frank Drives A VAN Home)
What did the FDA say in 2016 can be caused by taking a higher than recommended dosage of loperamide?
Serious heart problems that can lead to death
Bismuth subsalicylate adverse effects
Harmless black staining of stool
Darkening of tongue
What increases cardiovascular risk in patients who take loperamide?
High loperamide doses w/ inhibitors of CYP3A4, CYP2C8, or P-glycoprotein agents
In what patient groups should you restrict use of loperamide?
Patient who are afebrile or have a low grade fever w/ no bloody stools
This is to avoid super infection
Who CAN use loperamide?
Children 6 years and older
Patients who are allergic to ____ can NOT take bismuth subsalicylate
Aspirin
Who CAN use bismuth subsalicylate?
Patients older than 12
Can you get Reye’s syndrome from using bismuth subsalicylate?
YES but it is rare
What is a dose-related adverse effect of salicylate toxicity?
Mild tinnitus
Abbreviations: LABA
Long acting beta agonist
What patient groups can NOT use bismuth subsalicylate products?
- Pregnant/nursing
- Taking aspirin/salicylate containing drugs
- AIDS
- Taking tetracyclines/quinolones
- Urate lowering therapy
- Patients who have had the chickenpox/flu vaccine within 6 wks of taking BSS
- Bleeding risk
(Patients To Avoid Taking/Using Pepto Bismol)
What may be effective in preventing and treating mild, acute, complicated diarrhea?
Complementary therapy
Probiotics including several lactobacillus species
Bifidobacterium lactis
Saccharomyces boulardii
Abbreviations: ICS
Inhaled corticosteroid
Abbreviations: LTRA
Leukotriene receptor antagonists
Abbreviations: Rescue SABA
Rescue short acting beta agonist
Exclusions to self care of diarrhea
- Visible blood/pus/mucus in stool
- Signs of severe dehydration
- High output (includes frequent & substantial diarrhea volumes)
- Chronic/persistent diarrhea
- Risk of significant complications (includes chronic conditions/concurrent illnesses)
- Young age (< 6 months or weighs < 8 kg)
- Severe abdominal pain/distress (tenderness and/or distention)
- Sub potential response to ORS already taken
- Persistent fever
- Pregnant
(Very Sad Hannah CRYS, So Pour Pinnacle)
Signs of severe dehydration
Children showing behavioral/mental changes (irritability, apathy, lethargy, unconsciousness)
Children who have not urinated in 8 hours
Children who have no tears when they cry
Orthostatic hypotension
Patients of young age who should NOT be treated w/ an OTC antidiarrheal
Patients < 6 months old
OR
Weigh < 17.5 POUNDS (not kg)
Patients of advanced ago who should NOT be treated w/ OTC antidiarrheals
Frail patients
Older than 65 years old
Patients experiencing what should not be treated w/ OTC anti-diarrheal agents?
Persistent fever
Blood/pus/mucus in stool
Persistent vomiting
Signs of severe dehydration
Severe abdominal pain/distress
Chronic/persistent diarrhea
Suboptimal response to ORS already administered
